摘要：这3名患者在取得稳定的分子学缓解之后（融合基因转阴PCRU）停用达沙替尼。1名患者复发，另外两名患者在1年后仍保持了PCRU。以前说过，达沙替尼确实可以提高免疫力，希望今后能获得更多的相关研究报告。
c4 r- J$ S: z9 ]7 K# p5 x 关于这个研究值得注意的是，这三名患者都是服用格列卫失败后转用达沙替尼的，也即他们对格列卫是耐药的。这与法国的格列卫停药研究又有所不同，那个研究中的患者都是对格列卫反应良好的。希望医生们能扩大研究长期观察，看看停用达沙替尼是否能持久不复发。
! ^* N; {6 n( g3 t
w! K: B- ^1 j) U+ T) h% s作者：来自澳大利亚
. r6 |4 W. i5 g. C# B, _% ]来源：Haematologica. 2011.8.9.
3 _9 w- n5 m3 a, H7 i: TDear Group,( ?! l5 J" V+ e8 o5 N9 g/ t
8 q- U5 b' X8 t+ h& g8 ?+ pSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
% q" i; Q( R" Z8 i/ \, [ L8 vtherapies. Here is a report from Australia on 3 patients who went off Sprycel7 p* v$ B1 [8 u4 F
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients x8 Y1 B! N* {
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel6 S5 { s3 q2 I$ C
does spike up the immune system so I hope more reports come out on this issue." U9 u/ @' a( j. j: u
3 f3 @2 U/ A! ]! M+ ~
The remarkable news about Sprycel cessation is that all 3 patients had failed5 n) r3 a# k: c. Z& C }
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
6 @" O- b. _8 ndifferent from the stopping Gleevec trial in France which only targets patients
8 }1 f1 E" T/ A5 bwho have done well on Gleevec.& A* _1 D5 Q/ {) r+ X. x2 w1 a
4 B4 x Y9 z ?' {2 ]! RHopefully, the doctors will report on a larger study and long-term to see if the; a; X8 U- g/ n) h
response off Sprycel is sustained.8 t" w$ r' h$ g
% L7 l0 Y1 p# L2 Z# u
Best Wishes,
" Y# o5 @8 m( v8 q4 ?Anjana) ]9 x; G# T) t+ X4 e" v6 K3 m) ~
2 f8 I6 Q& i2 b3 X- R- s9 y
5 w7 }) ^- C( q0 S9 @. k9 \2 p
; K2 d* U# j$ \' M. }
Haematologica. 2011 Aug 9. [Epub ahead of print]
/ Q$ T) V( m/ N! n7 K, I* DDurable complete molecular remission of chronic myeloid leukemia following* @; z* p. w7 C
dasatinib cessation, despite adverse disease features.& c2 l8 _7 K0 t+ _9 z: T) r5 C
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
( d& H% N- V/ q. t2 o% NSource
/ M$ K( a; F" ^2 z, Y H3 h. PAdelaide, Australia;
9 z! G, G. W6 g4 W/ z3 V1 C, o6 l
- ?' n/ }# |9 ?) F6 V! O# OAbstract7 X; E2 k1 L' G. t; L
Patients with chronic myeloid leukemia, treated with imatinib, who have a
6 S, o/ S0 y$ u) W3 c0 _6 z2 [; sdurable complete molecular response might remain in CMR after stopping
- N( }$ d( y' @2 M9 k; \* x s6 K( V) Ztreatment. Previous reports of patients stopping treatment in complete molecular
: x2 r' F( P0 j2 ^6 [7 Mresponse have included only patients with a good response to imatinib. We& A7 O/ U; F; v7 G0 s% t) w
describe three patients with stable complete molecular response on dasatinib+ ]% z6 T0 j+ ~6 i
treatment following imatinib failure. Two of the three patients remain in
9 r' h% K& T3 P* F0 R6 i$ u2 o6 tcomplete molecular response more than 12 months after stopping dasatinib. In
M. q$ ?8 k( f Mthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
4 U* X1 ^' O7 ?( L5 B, rshow that the leukemic clone remains detectable, as we have previously shown in
. \6 ~' ~3 Q; B% P0 a2 G/ ?6 ^: Kimatinib-treated patients. Dasatinib-associated immunological phenomena, such as# L/ L+ u8 r1 g
the emergence of clonal T cell populations, were observed both in one patient; G q) s& n+ x; w
who relapsed and in one patient in remission. Our results suggest that the
4 W$ W8 d& a7 T- bcharacteristics of complete molecular response on dasatinib treatment may be# ^( P/ w# r5 I* k9 {* |
similar to that achieved with imatinib, at least in patients with adverse" t4 s C) ]! Y v
disease features.
1 p- `& {. B, m# j. w, d, _ |
显身卡
